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Annals of Nuclear Medicine and Molecular Imaging

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篇名 使用碘-131治療葛雷夫氏病後甲狀腺功能變化之追踪報告
卷期 13:2
並列篇名 Follow-up of Thyroid Function in Graves' Disease after Iodine-131 Therapy
作者 王世楨林萬鈺高嘉鴻林佳輝洪光威許晉誠
頁次 87-91
關鍵字 甲狀腺功能亢進低甲狀腺功能碘 131放射性同位素治療HyperthyroidismHypothyroidism[fef3]IRadionuclide therapy
出刊日期 200006

中文摘要

背景:使用放射性碘治療甲狀線亢進已被公認為一項十分有效的方法,其優點在於使用方便、安全、便宜。然而使用此項治療法仍有一些問題存在:未能立即控制甲狀腺功能亢進的狀況及隨後而來的低甲狀線功能。本回顧性研究分析過去幾年來葛雷夫氏病(Graves' disease)患者於本科接受碘-131治療的追蹤結果。
方法:本研究一共收集從1993到1997年於本科接受碘-131治療的117例葛雷夫氏病。這些病患皆因為內科治療失敗而轉介至本科接受碘-131治療。患者甲狀腺功能狀態的評估主要依靠臨床狀況及生化檢驗結果(包括血清T3、T4、TSH)。患者於治療後6個月接受評估,另一次較晚期的評估則於接受治療之後1年半進行。
結果:我們的研究結果顯示在治療後6個月,有38例(33%)患者呈現低甲狀腺功能,25例(22%)患者呈現正常甲狀腺功能,54例(47%)患者呈現甲狀腺功能亢進。在治療後1年半,有36例(31%)患者呈現低甲狀腺功能,38例(33%)患者呈現正常甲狀腺功能,43例(37%)患者呈現甲狀腺功能亢進。
結論:由我們的研究結果發現使用碘-131治療葛雷夫氏病發生低甲狀腺功能及再發甲狀腺功能亢進的情況相當多,所以對於使用碘-131治療葛雷夫氏病的患者必須給予密集的追?並給予適當的處置。

英文摘要

Background: Radioiodine therapy is an effective method of treating hyperthyroidism and has the advantage of safety, easy of administration, cheapness. The main problems associated with its use are delay in controlling hyperthyroidism and the ensuing high incidence of hypothyroidism. In this retrospective study, we tried to review the results of long-term follow-ups of patients with Graves' disease received 1311 therapy in our hospital.
Methods: This study includes 117 patients who underwent 1311 therapy between 1993 and 1998. These patients were irresponsive to antithyroid during treatment. The thyroid function status was judged on the basis of clinical and biochemical features. Patients were evaluated at 6 months after therapy. Late follow-up were repeated (at least 1.5 years after therapy).
Results: Thyroid metabolism study on patients 6 months after last therapy showed 38 patients (33.3%) with hypothyroidism, 25 patients (22%) with euthyroidism and 54 cases (47%) with hyperthyroidism. Late follow-up 1.5 years after last therapy showed 36 patients (31%) with hypothyroidism, 38 cases (33%) with euthyroidism and 43 patients (37%) with hyperthyroidism.
Conclusion: Our results revealed high incidence of hypothyroidism and recurrent hyperthyroidism after 1311 therapy of Graves' disease. Close follow-up after 1311 therapy is warranted.

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